建构“精神病患者”:心理学家对精神病理解的话语分析

Kitty Clark-McGhee, Maria Castro Romero
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摘要

背景:精神病是一个有争议的心理结构,在法医设置中用于理解法医服务使用者的心理。当代对精神病的研究表明本体论的混乱,评估实践的局限性以及对被确定为精神病患者的个体存在负面偏见。目的:适度的社会建构主义认识论是本研究的基础。它的目的是通过社会学调查来扩大精神病的临床框架,通过检查“精神病患者”是如何由一群直接与精神病患者标签的个人一起工作的专家话语构建的。方法:研究对象为8名临床心理学家,目前在英国各地的法医精神卫生机构(低、中、高安全医院)工作。进行半结构化访谈,并使用话语分析方法对数据进行定性分析。研究结果:分析表明,精神病患者被构建为有问题的个体,位于四个主要的、反复出现的话语区域:危险的、具有挑战性的、操纵性的和心理缺陷的。参与者使用“风险”和“创伤”话语来解释精神病的病因,“直觉”话语被用作精神病存在的标志。本文对研究结果及其临床意义进行了讨论。
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Constructing ‘the Psychopath’: A Discourse Analysis of Psychologists’ Understandings of Psychopathy
Background: Psychopathy is a controversial psychological construct used within forensic settings to understand the psychology of forensic service users. Contemporary research into psychopathy indicates ontological confusion, limitations with assessment practices and the presence of a negative bias towards individuals identified as psychopathic. Aims: A moderate social constructionist epistemology underpins this study. Its purpose was to widen the clinical frame of psychopathy via sociological inquiry through an examination of how ‘the psychopath’ is constructed discursively by a particular group of specialists working directly with individuals with a psychopathy label. Methods: Subjects were eight clinical psychologists currently working throughout the UK in forensic mental health settings (low, medium and high-secure hospitals). Semi-structured interviews were conducted and the data were analysed qualitatively, using Discourse Analysis methods. Findings: Analysis demonstrated that persons with psychopathy are constructed as problematised individuals, located within four overarching, recurrent discursive sites: dangerous, challenging, manipulative, and psychologically deficient. Participants utilised ‘at risk’ and ‘trauma’ discourses to explain the aetiology of psychopathy and ‘intuition’ talk was employed as a marker of the presence of psychopathy. The findings of the study and their clinical implications are discussed.
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